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[奎尼丁对犬右心室壁中吡那地尔诱导的复极跨壁离散的影响]

[Effects of quinidine on pinacidil-induced transmural dispersion of repolarization in canine right ventricular wall].

作者信息

Luo Jing, Yang Xin-chun, Wang Le-feng, Zhou Peng, Li Cui-lan, Wang Ming-sheng, Gao Ying, Wang Li-zhong

机构信息

Department of Cardiology, Beijing Shijingshan Hospital, Beijing 100043, China.

出版信息

Zhonghua Xin Xue Guan Bing Za Zhi. 2005 Apr;33(4):369-71.

Abstract

OBJECTIVE

On the basis that pinacidil can produce an "all or none" repolarization in right ventricular wall of canine, to observe the effects of quinidine on the marked transmural dispersion of repolarization. Recent studies have shown that ventricular myocardium is composed of at least 3 electrophysiological distinct cell types: epicardial, endocardial, and midcardial cells. Differences in the response of the 3 cell types to pharmacologic agents and/or pathophysiological states often result in amplification of intrinsic electrical heterogeneities, thus providing a substrate as well as a trigger for the development of arrhythmias. The study was designed to observe the right ventricular transmural heterogeneity in vitro canine heart tissue preparation level.

METHODS

The strips were isolated from the anterior wall of the right ventricular of canine. The preparations perfused with oxygenated (95%O(2)/5%CO(2)) Tyrode's solution. The tissues were stimulated at basic cycle lengths of 1000 ms. Standard microelectrode techniques were used. Transmembrane action potentials were recorded from epicardial, midcardial and endocardial cells respectively from right ventricular free wall of canine on different conditions [perusing with Tyrode's solution (Control), pinacidil (2.5 micromol/L), and quinidine (5 micromol/L) in turn].

RESULTS

Compared with that of endocardial cells, the action potentials of canine ventricular epicardial and midcardial cells had more obvious spike and dome morphology. Pinacidil (2.5 micromol/L) caused a loss of the dome of transmembrane action potentials and a marked abbreviation of the action potential duration (APD) in right ventricular epicardial and midcardial cells, especially in epicardial cells, but not in endocardial cells (n = 10). With pinacidil (2.5 micromol/L), in epicardial cells, phase 2 amplitude of action potentials decreased from (117.7 +/- 9.3) mV to (71.3 +/- 6.4) mV (P < 0.01), and 90% of the APD(90) decreased from (198.2 +/- 20.8) ms to (103.9 +/- 13.5) ms (P < 0.01). The transmural dispersion of action potential duration increased from (48.5 +/- 9.2) ms to (128.7 +/- 13.5) ms (P < 0.01). Quinidine (5 micromol/L) effectively prolonged the APD abbreviated by pinacidil, restored or partly restored the dome of transmembrane action potentials of epicardial and midcardial cells but not of endocardial cells (n = 10). In epicardial cells phase 2 amplitude increased from (71.3 +/- 6.4) mV to (106.6 +/- 7.7) mV (P < 0.01), and 90% of the APD(90) increased from (103.9 +/- 13.5) ms to (185.9 +/- 15.7) ms (P < 0.01). The transmural dispersion of action potential duration significantly decreased from (128.7 +/- 13.5) ms to (54.3 +/- 10.8) ms (P < 0.01). Quinidine reduced pinacidil-induced transmural dispersion of phase 2 amplitude and the APD in right ventricular wall of canine.

CONCLUSION

By restoring the dome and the APD of the epicardial and midcardial cells action potentials, quinidine (5 micromol/L) could reduce the marked transmural dispersion of repolarization caused by pinacidil.

摘要

目的

基于吡那地尔可使犬右心室壁产生“全或无”复极化这一基础,观察奎尼丁对显著的跨壁复极离散的影响。近期研究表明,心室肌至少由3种电生理特性不同的细胞类型组成:心外膜、心内膜和中层心肌细胞。这3种细胞类型对药物和/或病理生理状态反应的差异常导致固有电不均一性的放大,从而为心律失常的发生提供了基质和触发因素。本研究旨在体外犬心脏组织制备水平观察右心室跨壁异质性。

方法

从犬右心室前壁分离出组织条。用含氧(95%O₂/5%CO₂)的台氏液灌注标本。以1000 ms的基础周期长度刺激组织。采用标准微电极技术。在不同条件下[依次用台氏液(对照)、吡那地尔(2.5 μmol/L)和奎尼丁(5 μmol/L)灌注],分别从犬右心室游离壁的心外膜、中层心肌和心内膜细胞记录跨膜动作电位。

结果

与心内膜细胞相比,犬心室心外膜和中层心肌细胞的动作电位有更明显的锋和圆顶形态。吡那地尔(2.5 μmol/L)使右心室心外膜和中层心肌细胞的跨膜动作电位圆顶消失,动作电位时程(APD)明显缩短——尤其是心外膜细胞,但心内膜细胞未出现这种情况(n = 10)。使用吡那地尔(2.5 μmol/L)时,心外膜细胞动作电位的2期振幅从(117.7 ± 9.3)mV降至(71.3 ± 6.4)mV(P < 0.01),90%的APD₉₀从(198.2 ± 20.8)ms降至(103.9 ± 13.5)ms(P < 0.01)。动作电位时程的跨壁离散度从(48.5 ± 9.2)ms增加到(128.7 ± 13.5)ms(P < 0.01)。奎尼丁(5 μmol/L)有效延长了由吡那地尔缩短的APD,恢复或部分恢复了心外膜和中层心肌细胞跨膜动作电位的圆顶,但心内膜细胞未恢复(n = 10)。在心外膜细胞中,2期振幅从(71.3 ± 6.4)mV增加到(106.6 ± 7.7)mV(P < 0.01),90%的APD₉₀从(103.9 ± 13.5)ms增加到(185.9 ± 15.7)ms(P < 0.01)。动作电位时程的跨壁离散度从(128.7 ± 13.5)ms显著降至(54.3 ± 10.8)ms(P < 0.01)。奎尼丁减少了吡那地尔诱导的犬右心室壁2期振幅和APD的跨壁离散。

结论

通过恢复心外膜和中层心肌细胞动作电位的圆顶和APD,奎尼丁(5 μmol/L)可减少由吡那地尔引起的显著跨壁复极离散。

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